Patient Perspectives on Smoking Cessation and Interventions in Rheumatology Clinics.
Journal
Arthritis care & research
ISSN: 2151-4658
Titre abrégé: Arthritis Care Res (Hoboken)
Pays: United States
ID NLM: 101518086
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
13
03
2018
accepted:
12
02
2019
pubmed:
16
2
2019
medline:
11
7
2020
entrez:
16
2
2019
Statut:
ppublish
Résumé
Although smoking is a risk factor for cardiovascular and rheumatic disease severity, only 10% of rheumatology visits document cessation counseling. After implementing a rheumatology clinic protocol that increased tobacco quitline referrals 20-fold, we undertook this study to examine patients' barriers and facilitators to smoking cessation based on prior rheumatology experiences, to solicit reactions to the new cessation protocol, and to identify patient-centered outcomes or signs of cessation progress following improved care. We recruited 19 patients who smoke (12 with rheumatoid arthritis [RA] and 7 with systemic lupus erythematosus [SLE]) to participate in 1 of 3 semistructured focus groups. Transcripts of the focus group discussions were analyzed using thematic analysis to classify barriers, facilitators, and signs of cessation progress. Participant-reported barriers and facilitators to cessation involved psychological, health-related, and social and economic factors, as well as health care messaging and resources. Commonly discussed barriers included viewing smoking as a crutch amid rheumatic disease, rarely receiving cessation counseling in rheumatology clinics, and very limited awareness that smoking can worsen rheumatic diseases or reduce efficacy of some rheumatic disease medications. Participants endorsed our cessation protocol with rheumatology-specific education and accessible resources, such as a quitline. Beyond quitting, participants prioritized knowing why and how to quit as signs of progress outcomes. Focus groups identified themes and categories of facilitators/barriers to smoking cessation at the levels of patient and health system. Two key outcomes of improving cessation care for patients with RA and SLE were knowing why and how to quit. Emphasizing rheumatologic health benefits and cessation resources is essential when designing and evaluating rheumatology smoking cessation interventions.
Identifiants
pubmed: 30768768
doi: 10.1002/acr.23858
pmc: PMC6697238
mid: NIHMS1011952
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
369-377Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR000427
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002373
Pays : United States
Informations de copyright
© 2019, American College of Rheumatology.
Références
Ann Rheum Dis. 2012 Sep;71(9):1524-9
pubmed: 22425941
J Rheumatol. 2003 Jun;30(6):1215-21
pubmed: 12784392
Ann Rheum Dis. 2013 Nov;72(11):1771-6
pubmed: 23852694
Musculoskeletal Care. 2016 Mar;14(1):2-14
pubmed: 25982887
Rheumatol Int. 2014 Jan;34(1):93-9
pubmed: 24005567
MMWR Morb Mortal Wkly Rep. 2016 Nov 11;65(44):1205-1211
pubmed: 27832052
J Clin Immunol. 2004 Nov;24(6):617-22
pubmed: 15622446
Ann Rheum Dis. 2010 Jan;69(1):70-81
pubmed: 19174392
Arthritis Rheum. 2013 Jun;65(6):1430-8
pubmed: 23460074
J Clin Epidemiol. 2012 Feb;65(2):206-11
pubmed: 21862287
Arthritis Rheumatol. 2016 Feb;68(2):441-8
pubmed: 26359794
J Consult Clin Psychol. 1988 Aug;56(4):520-8
pubmed: 3198809
BMC Public Health. 2013 Mar 12;13:221
pubmed: 23497231
Ann Rheum Dis. 2017 Jan;76(1):17-28
pubmed: 27697765
Rheumatology (Oxford). 2008 Jun;47(6):849-54
pubmed: 18390589
Nicotine Tob Res. 2014 Sep;16 Suppl 3:S223-31
pubmed: 25118229
Ann Rheum Dis. 2014 Jul;73(7):1284-8
pubmed: 24608403
J Rheumatol. 2014 Apr;41(4):680-7
pubmed: 24532834
Rheumatology (Oxford). 2015 Aug;54(8):1528-30
pubmed: 26018439
J Rheumatol. 2015 Sep;42(9):1548-55
pubmed: 26178275
Rheumatology (Oxford). 2009 May;48(5):573-5
pubmed: 19273540
Arthritis Care Res (Hoboken). 2015 May;67(5):607-15
pubmed: 25370172
Am J Cardiol. 2011 May 15;107(10):1480-8
pubmed: 21414599
BMJ. 2000 Jan 1;320(7226):50-2
pubmed: 10617534
J Am Acad Dermatol. 2000 Jun;42(6):983-7
pubmed: 10827400
Hypertension. 1998 May;31(5):1136-45
pubmed: 9576126
Rheumatology (Oxford). 2006 Dec;45(12):1558-65
pubmed: 16705046
MMWR Surveill Summ. 2010 Apr 16;59(3):1-75
pubmed: 20395937
Arthritis Rheum. 1999 May;42(5):910-7
pubmed: 10323446
Vital Health Stat 13. 2011 Apr;(169):1-38
pubmed: 21614897
J Rheumatol. 1998 Sep;25(9):1716-9
pubmed: 9733451
Fam Pract. 2004 Dec;21(6):699-705
pubmed: 15528286
Arthritis Care Res (Hoboken). 2016 Apr;68(4):415-23
pubmed: 26315715
J Autoimmun. 2010 May;34(3):J258-65
pubmed: 20042314
J Womens Health (Larchmt). 2007 Jan-Feb;16(1):68-81
pubmed: 17274739
Arthritis Rheum. 2009 Mar 15;61(3):370-7
pubmed: 19248127
Lupus. 2008 Apr;17(4):337-47
pubmed: 18413417
J Rheumatol. 2016 Apr;43(4):691-8
pubmed: 26879360
Arthritis Rheum. 2011 Jan;63(1):26-36
pubmed: 20862678
Eval Health Prof. 2013 Mar;36(1):73-92
pubmed: 22523308
Ann Rheum Dis. 2017 Feb;76(2):364-370
pubmed: 27283333
J Okla State Med Assoc. 2015 Nov;108(11):492-9
pubmed: 26817068